| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
7,517 |
7,517 |
$397K |
| 92004 |
|
1,456 |
1,456 |
$74K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
736 |
736 |
$67K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,037 |
2,037 |
$53K |
| V2020 |
Frames, purchases |
2,350 |
2,350 |
$45K |
| 92015 |
|
8,751 |
8,750 |
$38K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
690 |
690 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
622 |
622 |
$10K |
| 92340 |
|
299 |
296 |
$6K |
| V2521 |
Contact lens, hydrophilic, toric, or prism ballast, per lens |
26 |
26 |
$2K |
| 99212 |
|
26 |
24 |
$427.50 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
13 |
13 |
$199.50 |